Organization
CANDID ILLINOIS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHESTER LYNN HURST (PRESIDENT)
(702) 738-5334
Entity
Organization
Contact information
Practice address
750 N FRANKLIN ST FL STC2, CHICAGO, IL 60654-6263
(702) 738-5334
Mailing address
750 N FRANKLIN ST FL STC2, CHICAGO, IL 60654-6263
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
04/19/2019
Last updated
04/19/2019
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